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Monday, 17 December 2012

Chapter 11. 1832: The year of the Cholera

The year 1832 was one of great political and social upheaval.

The battle for the Reform Bill – witnessed close at hand by Lord Falkland, who was given a peerage of the United Kingdom by his father-in-law that May, and keenly followed by James Barlow Hoy in Hampshire – led to riots in many areas.

The citizens of York burnt the Archbishop in effigy outside his palace when, through a misunderstanding, he voted to defeat the Bill [1]. In the pocket borough of Northallerton there were lively scenes in support of reform, with a great open-air party at Brompton.

When the Bill was finally passed, the change in suffrage necessitated another general election, and in December 1832 James Barlow Hoy stood again as candidate for Southampton, this time successfully.

It was also the year that established Mr Barlow in the affections of his parishioners and made his reputation for posterity. This was the year of the cholera.

For centuries, the term "cholera" was used to describe the violent diarrhoea and vomiting, and similar severe digestive disorders, that came in epidemics generally in late summer and early autumn. This was thought to be caused by

exposure to cold evening air after a hot summer's day, or from irregularities of diet [2].

Nowadays, after the pandemics of the 19th century, we associate the term only with the cholera morbus, or Asiatic cholera. Also known as spasmodic cholera, from the agonising spasms suffered by the patients – spasms which continued, frighteningly, after death – the first pandemic was witnessed by British doctors in India as it spread throughout Asia between 1817 and 1823. James Barlow Hoy had very probably encountered the disease during his time in India, and he would certainly have followed the reports of the Medical Boards of Bombay and Madras, and the accounts of his fellow medical men published at the time.

Cholera had always been endemic in pockets of India, but now, perhaps spread by the new conditions of greatly increased trade and British troop movements, it broke out explosively, and

soon produced on the minds of the medical attendants the strong conviction that it was a new disease – a most fearful Pestilence [3].

It swiftly passed its usual boundaries and spread widely and rapidly along the trade routes of Asia. An exceptionally severe winter prevented its further spread into Europe, but a second pandemic beginning in Bengal in 1826 spread rapidly across Asia and the middle East.

By August 1830 it had reached Moscow, and helped by large numbers of refugees from a savage military campaign in Poland, it travelled rapidly along thecomplex of busy trade routes across Europe. It carried with it a terrifying reputation, and even though its impact in Britain was far less damaging than had first been feared, it would cause over 31,000 deaths in England, Scotland and Wales in the years 1831 to 1832 [4].

The British quarantine regulations were developed from those devised to combat plague and yellow fever.

The Privy Council had the charge of the quarantine establishments and so Charles Greville, Clerk to the Privy Council, was actively involved in the matter. He noted in his diary of 19 July 1831 that the previous year

Government was thinking of Reform and other matters, and would not bestow much attention upon this subject, and accordingly neither regulations nor preparations were made.

The cholera had returned again with the warm weather, but

still we took no further measures until intelligence arrived that it had reached Riga, at which place 700 or 800 sail of English vessels, loaded principally with hemp and flax, were waiting to come to this country. [5]

At this point, quarantine was established for vessels from the Baltic and the government began consultations with eminent physicians as to the best methods of dealing with the approaching disease.

But what caused the cholera? There were essentially two theories, as Dr Simpson explained carefully in 1849:

According to the views of one party, Asiatic cholera is produced by a certain condition of the atmosphere, arising from some morbid agent or principle existing in that element, and is entirely irrespective of emanations proceeding from the persons of those who are subject to the disease.

The opinion of the other party is, that the disease is purely infectious or contagious, - that it arises from an animal poison or miasm, generated during the progress of the malady in one person, and capable of producing a similar malady in another person, who may happen to be within the range of its influence, and to be at the same time in a state of predisposition or susceptibility to its reception, this state of predisposition being determined by the present state or condition of health of the recipient.

Consequently, the state of health of people exposed to the "animal poison" was of the utmost importance. This was emphasised in the press before and during the epidemic, and certainly Dr Simpson found it to be the case:

Persons in the enjoyment of good health … who eat moderately of plain nutritious food at proper intervals,

who use wine moderately and avoid "long fasting, great fatigue, and continued watching", remain calm, composed and unafraid, paying "proper attention to personal cleanliness", wearing warm clothing, and taking daily moderate exercise in the open air, generally did not catch the disease, and so could assist the sick with the least possible risk to themselves [6].

The first opinion was that cholera was self-evidently contagious – it moved along the lines of water communication and major trade routes, travellers were often the first victims, and rigidly enforced quarantine was successful in keeping cholera out of communities.

However, doctors were puzzled to find that many contacts did not contract the disease – hospital attendants often escaped infection, and it certainly did not spread as rapidly from person to person as the plague – and as a result many Russian doctors had come to the conclusion that it was not in fact contagious.

The alternative theory, that it was spread by miasma – from changes in the atmosphere, vapour from the earth, or rotting vegetation – gained support from its association with the squalid conditions of the poor who so often fell victim to the disease.

Opinion was sharply divided over the matter, the anti-contagionists – according to Dr Simpson, a contagionist, and the Medical & Surgical Journal, quoted in his work – being very vocal out of all proportion to their support in the medical world. This caused Greville considerable difficulty:

The public requires that we should take care of its health, the mercantile world that we should not injure their trade. All evidence proves that goods are not capable of bringing in the disorder, but we have appointed a Board of Health, which is contagionist, and we can't get them to subscribe to that opinion. We dare not act without its sanction, and so we are obliged to air goods. This airing requires more ships and lazarets than we have, and the result is a perpetual squabbling, disputing, and complaining between the Privy Council, the Admiralty, the Board of Health, and the merchants.

Or, as Dr Simpson wrote in 1849:

If quarantine could be strictly enforced, there cannot be the slightest doubt that it would be successful. The difficulties, however, of enforcing quarantine, between countries where extensive commercial intercourse is constantly going on, would appear to be quite insurmountable.

Traders who found themselves obliged to pay government fees and extra wages for their crews complained; some London merchants claimed that as a result the ships could only make one trip instead of two that season. Loss of trade was feared moreover because it would entail loss of work and so increase destitution amongst the poor, whose living conditions were generally assumed to make them more vulnerable to the disease.

There were growing calls for changes to the regulations, but nevertheless there remained manufacturers who supported the measures, fearing the consequences of the unpacking in crowded factories of bales of wool or flax packed in areas where cholera was rife. For a time the quarantine measures seem to have been successful.

The Board of Health had considered the possibility of internal quarantine to limit the spread of cholera once it arrived, but it was obviously impracticable. Given the terrifying nature of the disease reported in Asia and eastern Europe, they recommended local isolation of the first cases and the separation of the sick from the healthy. This was to be done by a network of local Boards of Health. The Board envisaged the removal of the sick into cholera hospitals, and thence into convalescent homes, while their contacts would be taken into isolation houses; if all three buildings could be in the same enclosure, this could be conveniently guarded by the local military. Their homes would be purified with chloride of lime and hot lime wash; the dead would be buried swiftly in ground close to the house for the infected. Their first circular, published in the press, called for local Boards to be established,

There should be established a local board of health, to consist of the Chief and other Magistrates, the Clergyman of the parish, two or more Physicians or Medical Practitioners, and three or more of the Principal Inhabitants…

The Central Board advised the magistrates to prevent, as far as possible, intercourse with any infected town. Magistrates and clergy were asked to improve the conditions in which cholera spread:

the poor, ill-fed, and unhealthy part of the population, and especially those who have been addicted to the drinking of spirituous liquors, and indulgence in irregular habits, have been the greatest sufferers from the disease….

This circular was published on 20 October 1831 shortly before the news of the first official case of cholera was confirmed in Sunderland in late October.

Almost certainly there had been earlier cases there, amongst them a river pilot who had brought a Baltic ship in and out of the River Wear in early August 1831. Quarantine in Sunderland had not been entirely successful. The port had nowhere to keep quarantined vessels outside the river mouth because of the nature of the coast, and so had been obliged instead to retain them in an anchorage normally used by over-wintering colliers.

There it is said they were kept under little guard, and it was reported that the crews of three Hamburg ships had been able to go ashore each night. The disease may have reached the port either through these men, or from the Riga flax boats, or the chests of clothes of victims of the Baltic cholera which also arrived in Sunderland that August.

Early cases went unrecognised principally because the disease did not present in the way everyone had come to expect.

The history of the pandemic in the east and its fearsome reputation had led doctors to believe that it would spread swiftly in an explosive epidemic; in Sunderland, on the contrary, they experienced a slow spread of unusual, serious cases during several weeks.

In part the early cases also went unnoticed because of the failure of the town's physicians to recognise the expertise of James Kell, surgeon to the reserve division of the 82nd Regiment of Foot stationed in the town. He had treated cholera in Mauritius, but unfortunately his lowly position in the medical hierarchy – not only a mere surgeon, rather than a physician, but an army surgeon at that – together with his lack of local connections did not inspire their trust and confidence [7]. "All the medical men of the place considered" [8] that, contrary to Kell's views, cholera was not contagious.

Kell correctly identified cholera in the case of the first official victim, a Sunderland keelman called William Sproat, and had him removed to the Infirmary. There however the doctors pronounced that it was "the common cholera of this country attended with aggravated symptoms"; Kell was not able to examine Sproat again, as he was not one of the consultants of the Infirmary and could only enter by their invitation.

Within a few days, the death of an Infirmary nurse was generally agreed to be from Asiatic cholera and the local Board of Health notified London accordingly. Within days, and several new cases, a meeting was held of the principal inhabitants, some medical men and the High Sheriff, with the chief magistrate acting as chairman, at which the doctors who had reported cases to London were censured.

Feeling ran high, because the shipping interest objected strongly to the disruption of the coal trade, and the rigorous enforcement of quarantine on shipping by the Navy was in stark contrast to the free running of mail coaches to London. The Sunderland keelmen, their livelihoods threatened by the drop in trade, were threatening to "burn the doctors", and given the past record of the mob in the town – in 1816 the keelmen and casters pulled down a new bridge and staithe – the threat was not to be taken lightly. Many in Sunderland of all classes simply did not believe that the sickness was the Asiatic cholera of which they had heard so much; this small-scale outbreak of sickness did not seem to warrant the expensive precautions demanded by government. It was believed that the sickness was serious, but most thought it was not infectious. However, as Dr Clanny admitted, the doctors soon realised that the cholera was "highly contagious" [9].

In response to the outbreak, carriers' carts from Sunderland were forbidden entry to Stockton, Staindrop and Barnard Castle by the towns' authorities. However, no real internal quarantine could be effected; the economic disruption it would have caused appeared disproportionate to the risk.

This practical difficulty can be seen in the modification of the strong measures initially advised by the Central Board. This was reconstituted in November 1831 to include men who had seen and treated cholera in Russia, where they had seen that coercive methods lead to riots and popular distrust. They knew that the British would not take any more kindly to such methods, and they accordingly favoured persuasion.

Their second circular was published on 14 November. Any deficiencies in local preventative measures were to be remedied by "any means individual and public charitable exertion can supply". "Good sense and good feeling" were relied on to support quarantine and isolation. The public were warned that there was no specific treatment – people were to pay particular attention to fresh air and cleanliness, though “the true preventatives are a healthy body and a cheerful unruffled mind”.

The third circular, on 13 December 1831, did not mention quarantine, but paid particular attention to cleansing and burials. It urged people to take action in remedying the conditions in which the poor lived:

The most effectual means by which this disease may be prevented from extending, is to enable the poor, who are generally the first attacked, to oppose to its influence, as far as practicable by those ameliorations in diet, clothing, and lodging which public and private charity, will it is hoped not fail to produce.

The cholera had revealed to the ruling classes, in Greville's words,

scenes of misery and poverty far exceeding what one could have believed it possible to find in this country; but we who float on the surface of society know but little of the privations and sufferings which pervade the mass [10].

"The awful thing," he wrote on 1 April,

is the vast extent of misery and distress which prevails, and the evidence of the rotten foundation on which the whole fabric of this gorgeous society rests, for I call that rotten which exhibits thousands upon thousands of human beings reduced to the lowest stage of moral and physical degradation …

From Sunderland, the disease spread to Newcastle, which was to experience one of the worst outbreaks for a town of its size in the kingdom. This must have caused some concern to the weavers of Hutton Rudby, as they had considerable trade with the city; indeed Clark, Plummer & Co of Newcastle kept an agent in the village.

The disease spread slowly into Scotland, and across Northumberland and Durham, with explosive epidemics in Gateshead and the colliery village of Newburn, where more than half the village was affected.

The York Herald report in January 1832 on cholera in Newcastle reflected the current medical opinion that diarrhoea left untreated could lead to cholera, when it commented that

a considerable share of the mortality might have been prevented if the diarrhoea had been properly attended to.

The writer noted that the disease followed rivercourses, and that there was a great deal of filth in the city, with dirt abounding in front of dwellings, whilst the inhabitants' food was chiefly indigestible items such as cheese and ham, unsuitable for consumption in a cholera epidemic.

By January 1832, the government's position on the quarantine of shipping was becoming untenable, and by March when cholera had established itself in London it was evidently pointless. Obstacles to trade could only increase the destitution of the poorest and most vulnerable members of society. Other precautions were still to be taken. On 15 February 1832, the Bishop of London directed his clergy in no case to permit the body of a person who had died of cholera to be carried into the church before burial.

The Board of Health circulars, and the reports of the local boards, will have been read – with what degree of attention or belief, we do not know – by Mr Barlow, George Brigham and other thinking men and women of Hutton Rudby. They must have been considerably alarmed by the outbreak of cholera on the Wear and the Tyne, given the village's extensive trade with Newcastle. Possibly Mr Barlow corresponded with his brother James for advice. He himself was quite accustomed to epidemic diseases – apart from the experiences of his early life in the city of Dublin, during his curacy in Belfast there had been an epidemic of a "fever of a malignant type" [11], possibly typhus, and he had been active and assiduous in helping the patients.

A central Board of Health for the North Riding was established in Northallerton on 9 November 1831 [12], and boards were created in each division.

These divisional Boards wrote to their constituent townships with instructions to form local Boards. Some of the responses to this are known: Kirkleatham carried out an examination of the parish, Cleasby established a Board immediately, and in Guisborough men were employed to remove "nuisances".

This term was customarily used to describe conditions which were then usual but are now unthinkable – the filth that flowed from the dung heaps, privies, pigsties and cesspools that were to be found beside houses and along the streets of an early 19th century town or village. In the absence of any theory or explanation as to why these would be dangerous to the health, to our forebears they were simply "nuisances". We do not know whether any similar action was taken in Hutton Rudby, as the only records of vestry meetings that survive from this period are the churchwarden's accounts.

Local authorities throughout the country were encountering difficulties in their attempts at protecting their communities.

The government had recommended measures which were impossible to carry out. Stockton found itself "virtually prohibited" from removing nuisances, and could not carry out its plans to stop, unload and disinfect carriers' carts. In London, the secretary to the Brompton Board found he could only enforce the removal of nuisances by presentment at the Sessions, every three months, and that only if the property owner's name was known. York found it was legally unable to exclude vagrants effectively. Southwark was advised that there was little point in inspecting the water supply, as they had no power to take action.

Where vestries refused to vote money to take health measures, there was no means of compelling them – and it was not strictly within the power of the vestries to vote the money in any event. The cholera was presenting a challenge to the fast developing towns and cities of Britain which, ironically, seems to have posed no problem to a vicar such as Mr Ibbetson of Great Ayton, whose control of his vestry was apparently complete.

The government took speedy action and the Cholera Act was passed in February 1832, granting authority and making funds available for local boards to act effectively. Local boards of health would have the power to enter dwelling-houses, remove nuisances, acquire special burial grounds, provide relief for the sick and cover their expenses.

On 6 March 1832, an order of the Privy Council enabled communities threatened by cholera to set up local boards of health that could be authorised to provide medical care; if the parish vestry refused to grant the board of health the necessary funds, the board could apply to the Privy Council. An order of 20 July 1832 gave boards of health powers of entry to clear nuisances etc, and required the burial of cholera victims within 24 hours of death.

By the spring of 1832, cholera had broken out in Darlington, Hull, Selby and Leeds. The first case was reported in York on 2 June 1832, and was thought to have been brought to the city by crowds coming to the races. The city was prepared, and was

perfectly healthy at the time … the streets had been perambulated at stated periods, by persons appointed for that purpose [13],

who were organised into sections, to each of which a medical man was attached. When the outbreak began, Dr Simpson and a noted York surgeon Mr J P Needham immediately began an investigation to trace the cases.

Needham's monograph demonstrating that the disease was contagious was published in 1833; in the second pandemic of 1849 Simpson produced his book, a clear exposition of the contagionist viewpoint supported by case studies, which was quoted by Dr John Snow in his celebrated work on cholera. In the event, York had 450 cases, comparing very favourably to the much higher rate of infection in the manufacturing towns, which Simpson felt reflected their respective living conditions.

However, as the disease had so far not shown itself as frighteningly virulent as it had been feared before its arrival, public response was frequently less than enthusiastic for expensive preventative measures. On 25 July 1832 Thirsk decided against the appointment of a Board, believing that the town officials would have "sufficient power" to meet the usual contingencies. During August, cholera broke out in Whitby – and here the true scale of the pandemic can be seen, as it may have been introduced by seamen returning from America.

On 17 August the disease came closer to home, when it broke out in the crowded streets of Stockton-on-Tees. This was the main trading port on the river and Hutton Rudby had close links with the town. As cholera deaths in Stockton rose, concerns grew for the state of the graveyard at the parish church, which was already extremely overcrowded. Many feared that to bury more victims there would extend the epidemic, and that in years to come future burials on the site might reawaken the disease [14]. A separate burial ground, in accordance with the Privy Council instructions, was established just outside the borough boundary, and later became part of the Holy Trinity Churchyard. There were 126 deaths from cholera in Stockton during August and September.

Hutton Rudby's Vestry does not seem to have taken any action at this point; they did not form a Board of Health, and they make no mention later of having cleared any nuisances.

However, the Select Vestry of Great Ayton voted on 30 August to take immediate measures. It was

unanimously resolved that in consequence of the near approach of the alarming Disease the Asiatic Cholera, this meeting deems it necessary to form a Committee for the purpose of using every needful precaution, and of adopting such measures as the case requires.

The Revd Joseph Ibbetson with the surgeon and other select vestry members inspected the village the following morning to

require that all nuisances be immediately removed.

Surgeons were to visit any poor person immediately they were found to be suffering the symptoms, and the surgeons' expenses were to be paid by the vestry [15].

Elsewhere in Yorkshire private charity was providing assistance to the poor. In York, the York Herald announced that Mr David Priestman had arranged with the doctor to cover the cost of medicines for the poor afflicted with cholera, if they were obtained from Mr Kingsley, the druggist. By 13 August, Priestman had already paid £17 for this purpose; he had also declared his readiness to provide good food and clothing for the destitute in his neighbourhood.

By the summer of 1832, the epidemic had been in the British Isles for nearly a year. Public reaction had varied.

Early newspaper reports from Europe had both alarmed and reassured the middle class reading public. The impression was given that victims were mostly to be found amongst the undeserving poor – although examination of the figures from Russia and Germany showed that all classes suffered in proportion to their share of the population – and newspapers and doctors continued to reflect this view when cholera arrived in Britain. Two physicians who visited the North East reported to a Leeds meeting that in Newcastle only three respectable people were attacked by the disease, the remainder being

of the lowest class, living in crowded apartments and addicted to habits of intemperance.

The Times on 13 February 1832 stated that

The real causes of the disease are poverty, bad living, insufficient clothing, dirty streets and dwellings, united with occasional excess.

On the other hand, the radical press viewed the government's reaction with the deepest suspicion.

They believed it to be a cynical distraction from the real business of the Reform Bill, and saw as corrupt profiteering from the public purse the increased demand for the services of doctors, apothecaries and druggists. They took a very low view of employers who, having recently reduced their worker's wages, publicly made charitable donations to relief funds.

Such suspicions persisted for months, even to the extent that the newspaper reports of the cholera deaths were not believed. Even when Manchester had seen over a hundred cases, it was said that

the word cholera could not be seriously mentioned in some companies without a man's running the risk of being called a credulous fool or a terrified dupe [16].

This was undoubtedly reinforced by their belief that cholera was caused by want and wretchedness, requiring a political response. They could not help but notice that the authorities had not taken the same view of typhus, of which there was also an epidemic.

Indeed the government reaction, with its emphasis on doctors and hospitals, was part of the problem.

The poor and working classes of the time had a difficult relationship with the medical profession because of the recent scandals of the "resurrection men". As medical knowledge increased, so had the demand for fresh bodies for dissection in the medical schools. The only legal source of these was from the execution of criminals, and the numbers were quite inadequate. Doctors grew less scrupulous in their suppliers, who were paid increasing amounts for their "subjects". The price for a body went up from four guineas in 1812 to ten guineas in 1828. The "body-snatchers" took corpses from fresh graves, and finally, in the case of Burke and Hare, took to murder on demand.

Amongst the poor, there was a deeply felt need for providing the bodies of family and friends with a proper burial, and there still remained old beliefs in the need for the body to remain intact for resurrection day. The anatomists and the body-snatchers threatened these customs and riots were not uncommon. In Glasgow there were several occasions where troops had to be called out to protect doctors and in 1831 the Anatomy Theatre at Aberdeen was pulled down after body parts were discovered nearby.

The dilemma was acute, but the need for medical education was great and the study of anatomy was vital. The rich could protect their graveyards with patrols and mantraps, while the poor were vulnerable to the body snatchers – and yet it was the poor who would suffer most from the inexperience and lack of training of the newly qualified doctors working amongst them. The Anatomy Act of 1832 was the final compromise, making available to the medical schools the bodies of those who died in prisons, hospitals and workhouses unless they were claimed by friends or relatives, or the dead person had specifically objected before death.

Unfortunately, a deep distrust of doctors remained, and consequently the poor objected strongly to being removed from home and taken, often in squalid conditions, to a cholera hospital, where they would be at the mercy of the anatomists. They felt bitterly the requirement that burial should take place as soon as possible, the body wrapped in cloth saturated with pitch or coal tar, and the service carried out in the open air and attended by as few people as possible.

The further down the social scale and the nearer to Scotland and Ireland, the more distress was felt about the prohibition on spending time over the funeral and making direct physical contact with the body.

Fears of being buried alive added to the anguish. In early 1832 the Haddington Board of Health denied reports that a labourer had been buried alive – the violent spasms reported had occurred after death.

Nor did the poor welcome visits by authorities inspecting and whitewashing their homes and burning infected clothing and bedding. Consequently, medical men met with violent resistance and there were serious riots in many places.

Generally, however, whatever fears the public felt were not sufficient to alter their normal behaviour. Where cholera struck, the immediate community was affected and everyday life was replaced by management of the disease, but in the unaffected areas life carried on as normal. On 14 April 1832, Greville commented on the contrast between London and Paris:

The accounts from Paris of the cholera are awful, very different from the disease here. Is it not owing to our superior cleanliness, draining, and precautions? There have been 1,300 sick in a day there, and for some days an average of 1,000; here we have never averaged above fifty, I think, and except the squabbling in the newspapers, we have seen nothing of it whatever; there many of the upper classes have died of it.

In fact where outbreaks occurred, people nearby often hastily left the neighbourhood. It is said that 700 people a day left Paris at the peak of the epidemic and scenes on a similar scale were reported in Dumfries, where there was one of the most serious outbreaks in Britain. According to the Leeds Intelligencer of 11 October 1832,

The inhabitants were fleeing from the pestilence. Many of the fugitives died on the roads and in the fields … when wheels are heard the public expect to see either a hearse or a doctor's carriage.

The inexplicable nature of the disease was fertile ground for moral explanations.

Evangelicals of all denominations tended to see cholera as retribution for the sins of the victim or of society as a whole. It was linked with drunkenness, immorality, Sabbath breaking and swearing. Religious revivals occurred as a result – in Gateshead, the Methodist chapels gained 300 new members. A General Fast was proclaimed by the King on 21 March 1832 – the Yorkshire Gazette carried the announcement on 11 February –

beseeching God to remove from us that grievous disease with which several places in the kingdom are at this time visited.

The churches and chapels were filled, but in certain circles, such as the radicals and the Unitarians, the very idea of a Fast Day was greeted with derision.

On 6 July 1832, far off in the parish of Carshalton in Surrey where there had been an outbreak of cholera, Mr Barlow's future neighbour the Revd Charles Cator preached to his congregation on "The Cholera Morbus, a visitation of divine providence" [17].

The abuse of alcohol was frequently linked with vulnerability to cholera, by the newspapers and the doctors. It struck a chord with the public, as this was the dawn of the temperance movement, and alcohol now carried increasing associations of poverty and lack of self-control. Moreover, the usual medical advice was to abstain from strong liquor during the epidemic and take wine in moderation. In fact the gastritis and malnutrition caused by excessive use of alcohol did favour the disease.

As the weeks passed into autumn, Hutton Rudby remained unaffected. By October, they must have become quite accustomed to the situation.

There were weekly reports in the Leeds and York newspapers of the progress of the disease, publishing the figures supplied by the doctors to the local Boards of Health. Newspapers did not then employ banner headlines, and the bulletins were to be found in the usual small type amongst the other items of news – on 11 October 1832, for example, the Leeds Intelligencer reported that "there is no material diminution in the progress" of the cholera (there had so far been 1,700 cases and 661 deaths), while a little further down the page can be found the report of the Leeds Union Musical Society meeting in the Masonic Room, with adjournment to the Albion Inn.

Frequent references to the dirty nature of affected neighbourhoods and explicit comments on the deaths among the "respectable class of inhabitants" [18] also served to distance the reader from the epidemic.

The newspapers had been filled with advice and conflicting opinions for months. There were still many, including doctors, who maintained that the so-called Asiatic cholera was in fact merely an aggravated form of the well-known English cholera. At the time, epidemic diseases such as typhus, smallpox, scarlet fever and influenza were rife and part of everyday life – there were many serious epidemics during the 1830s and 1840s.

We now know, as they did not, that cholera is caused by the ingestion of the bacterium 'vibrio cholerae', usually in water containing the excreta of someone already infected by the disease. The celebrated work of Dr John Snow in 1855 demonstrated that cholera was a water-borne disease (Dr Simpson believed it was air-borne), as he had famously demonstrated with the removal of the handle of the Broad Street pump, but it was not until 1883 that Robert Koch conclusively showed that this was the case by isolating the cholera vibrio.

Cholera is difficult to catch, and in most cases the stomach acids defeat the vibrio – it was noted in 1876 that out of nineteen people drinking from a infected vessel, only five contracted the infection [19] – but without treatment it is fatal in half the cases.

At first the victim might feel "dizziness, faintness and a feeling of sinking", but the

disease often proceeds with so little feeling of general illness that the patient does not consider himself in danger, or even apply for advice, till the malady is far advanced [20].

The subsequent vomiting and the massive diarrhoea – possibly up to a fifth of the body weight might be lost in one day – ends in the classic diagnostic sign of the grey liquid known as "rice water stools" and causes rapid dehydration. The collapse stage follows, and if, as the Edinburgh surgeon George Hamilton Bell noted

the case be accompanied by spasms, the suffering of the patient is much aggravated, and is sometimes excruciating [21].

The patient in this stage has sunken eyes, livid skin, blue nails, and

the skin of the hands and feet are corrugated as if they had been long steeped in water [22].

This stage can last from two hours to a week or longer, and the doctors found that most deaths occurred at this point. The next stage is fever, for which careful nursing was required.

We now also know that the vibrio can be spread by infected food, surviving for two to five days in meat, milk and cheese, and for slightly less in green vegetables. Several fruits give it a favourable home – it survives up to sixteen days in apples. It lasts only eight hours in beer and wine. Flies, infected clothing and blankets can transfer the vibrio to the hands and food. Dr John Snow noted that:

the bed linen nearly always becomes wetted by the cholera evacuations, and as these are devoid of the usual colour and odour, the hands of persons waiting on the patient become soiled without their knowing it.

At nine o'clock in the evening on Tuesday 2 October 1832, the weaver John Cook – one of the men who had searched Robert Goldsborough's house after William Huntley's disappearance – came back home to the Bay Horse Yard.

He had been in Newcastle, probably on business – it was common for weavers to go many miles on the tramp for their work. He had not been well for a while before leaving home, presumably with a stomach complaint, but his state of health had caused some alarm in Newcastle, perhaps to his landlady who feared "premonitory diarrhoea". He was taken to the cholera hospital, which he left on the Monday.

Unfortunately it seems clear that it was while in the hospital that he contracted cholera. By the time he reached home he was very ill. His wife and neighbours assumed that this was his earlier illness in a more serious form. They did not call for the doctor, perhaps because John Cook collapsed so swiftly that they found no time to do so, or because they believed there was nothing more a doctor could do for him. He died within a few hours of coming home.

The women will then have opened the window for a time to let out the dead man's soul before proceeding to wash his body and lay it out, tearing up rags to stop the orifices. [23] By morning they must have thrown out onto the dunghill the dirty water and any slops from the poor man's diarrhoea. The dunghill was probably near the cowhouse at the edge of the fields, on the north side of the yard. At the centre of the yard was the well [24].

On the east side of the yard stood a small terrace of buildings overlooking Hutton Bank. Nearest to the green was a smithy, separated by a passageway from a building probably used as stables, and beyond that stood the Bay Horse Inn itself. It had been kept for many years by the blacksmith James Catchasides and his wife Grace.

Across the road at the top of the bank, James had a garden and a garth of about an acre, on which he had his stackyard, barn, cowhouse and pighouse. He had sold his property to Edward Rhodes in February 1831, but seems to have stayed on as tenant. Their son Stephen lived either with them or close by – it was he who took down the silver watch from Robert Goldsborough's chimney piece on the day they looked for traces of William Huntley. He had probably taken on most of the work at the smithy as his father grew older. Also with them in October 1832 was their married daughter Betty Skelton.

To the north of the Bay Horse Inn, a two-acre garth ran down to the river; there was a cowhouse at the top of the garth. On this northern side of the yard there was also a garden and a warehouse. Facing the smithy and the inn stood another small terrace of houses, and to the south, beside the green, there was a grocer's shop [25].

Top of Hutton Bank, early C20 - the shop is on the left

In 1832 some of these buildings were quite new [26]; they had previously belonged to James Catchasides junior, who kept the grocery there. He had sold up in February 1830 to become a miller at Stockton, and his shop was now rented by Henry Bainbridge from Thomas Hall of Ormesby. Bainbridge and his family had arrived in the village a couple of years earlier.

The ground in the yard slopes slightly down to the east and south, so that water would run into the middle of the yard, and slops thrown onto a dung heap near the cowhouse would leak down towards the well.

A message must have been sent to Mr Barlow in the morning, so that the funeral could be arranged. However, the details of John Cook's illness raised alarm in some quarters, and as a result Mr Barlow carried out the funeral that very afternoon, and did not allow the body to be brought into the church before the service at the graveside. As Mr Barlow does not claim to be the originator of this alarm in his account [27] – and he was not a man to hide his light under a bushel – it was probably the doctor, Thomas Pulman, who raised the matter with him. He and Mr Barlow then chose to carry out those precautions advised by the government which lay within Mr Barlow's power alone, and which did not intrude into the homes of the widow and her neighbours. They must then have hoped for the best.

Unfortunately, the disease was already among them. It is very likely that those who nursed John Cook, laid out his body and washed his clothes and bedding took the disease from him into their own homes and food – and probably onto the groceries for sale in Mr and Mrs Bainbridge's shop. However, the explosive nature of the following outbreak and the fact that women were not among the first to die shows that the primary source was almost certainly the water supply in the yard.

We might wonder why people would drink the contaminated water. Examples quoted by Dr John Snow [28] explain the matter. At the time of the Broad Street epidemic in 1854, people generally had not observed any change in the character of their water, and it "passed with almost everybody as being perfectly pure".

However, one informant had noticed that for a long time the water became offensive, both to smell and taste, after it had been kept about two days, which Snow commented is a characteristic of water contaminated with sewage. Another informant had noticed for months that a film formed on the surface of the water when it had been kept a few hours. One gentleman had been out of town at the beginning of the outbreak, and when he returned home and sent for some water he was surprised to find that though it was perfectly transparent and fresh from the pump, it smelled offensive.

Moreover, people were accustomed to drinking water which we would nowadays refuse – an incident near Bath in 1849 shows that this was not confined to the lower classes. There was an outbreak of the 1849 epidemic in a village near Bath, whose inhabitants complained of their drinking water to their landlord. His surveyor examined the water and declared there was nothing the matter. The tenants continued to complain, and the owner went to visit them himself on the Wednesday. He looked at the water and smelled it and said he could see nothing the matter with it. He was asked if he would taste it, and he drank a glass. He returned home – where there was no cholera in the neighbourhood – and died of the disease on the Saturday.

Snow also cites instances of people drinking the water, and nevertheless blaming it for their illness.

As explaining how persons might drink of such water before finding out its impurity, it may be stated that the grosser part of the material from drains and cesspools has a tendency, when mixed with water, to settle rapidly to the bottom.

They would then discover offensive dregs at the bottom of the glass.

Water was not simply drunk straight from the well or the water-butt, but was also added to effervescing powder to make sherbet, which was sold in shops and was particularly popular with children; adults would mix it with spirits, or drink it as a thirst-quencher after neat spirits.

By Thursday morning it was clear that cholera had broken out in the Bay Horse Yard. On Friday 5 October, a meeting was held and the following morning Mr Barlow wrote to London to establish a Board of Health in the township, hoping to receive the orders from the Privy Council on the Wednesday.

It is interesting that it was necessary to go through the official channels, rather than setting up a Board at once, a course which seems to have been available to them. It is not clear whether the meeting was open to all or was a meeting of the select vestry. Perhaps insufficient numbers attended, because some were people suffering from the cholera, some had left the village, and others were unable or unwilling to come into the village for the meeting – or perhaps those present were not sufficiently sure of their fellow vestry members to take on the responsibility in their absence.

Over the following four days, Mr Barlow took thirteen funerals: four on Saturday, six on Sunday (of which one was the doctor, Thomas Pulman), two on Monday and one on Tuesday. Quite apart from the distressing circumstances, this will obviously have presented practical difficulties. The government required that:

Those who died of this disease should be buried as soon as possible, wrapped in cotton or linen cloth saturated with pitch, or coal tar, and be carried to the grave by the fewest possible number of persons. The funeral service is to be performed in the open air.

Authorities varied in how strictly they enforced the regulations, some using quicklime in addition. Many towns and cities, like Stockton and York, established separate burial grounds, as indicated by government regulations.

In Hutton Rudby the cholera dead were buried on the north side of the church. This is traditionally the less-favoured area of the graveyard, but it may have been the area then being used – in a small churchyard, the ground was re-used repeatedly until relatively recent times. The late vicar, Mr Shepherd, had been buried there in 1830, close to the vestry door, and it is possible that as John Cook was buried there it became the natural site for the following victims.

The parish possessed a bier – a sturdy four-wheeled trolley – which will have been useful in the circumstances. It is not known whether the bodies were coffined. Obviously, Mr Barlow could not know how many deaths to expect, and we do not know how the burials were planned. The final result was the cholera mound, which must have been created so that future gravediggers would recognise the site and not disturb it for later burials. By 1924, the mound was "surmounted by an old elder tree" [29]. It is presumed that all the victims were buried there, even where their names are recorded elsewhere on family gravestones [30].

On Tuesday 9 October, Mr Barlow wrote a report to George Brigham in his official capacity as coroner and chief constable. The letter shows how pressed he was for time:

Mr Brigham
Windy Hill

Mr Barlow presents his compliments to Mr Brigham and begs he will communicate the following to Lord Falkland.
First in his own name and that of the Parish he wishes to express sincere thanks for his kind and benevolent aid which shall be employed to the best advantage.
The number of deaths has been 12 from the commencement; three new cases occurred this morning which makes in all 12 cases of each of which hopes may be entertained except one child.
The Medical Gentlemen in constant attendance are Doctor Keenlysides of Stockton and Doctor Allardice of Stokesley besides Junior aid, we have also had occasional and chance visits from Dr Young of Yarm and Doctor Cock of Stockton
Every possible care has been taken to fumigate with chloride of lime, common lime and tar and also to destroy and take care of the clothes, the bodies too have been promptly interred –
On Saturday (after a meeting held on Friday) I wrote to have a Board of Health established which power will arrive here to-morrow from London
Mr B sent a Doctor on to Middleton but it was a false alarm as to the Mother and the infant was not a case of cholera –
Mr B received Sir Wm Foulis letter and will return him thanks –
Mr B had not time to write to Mr Brigham yesterday
Linden Grove
Octr 9th

We have several sources of information for the cholera epidemic: two letters by Mr Barlow, one by Dr Allardice, the official reports of the number of cases, deaths and recoveries carried in the press, and an account written in 1849 by a young Stokesley doctor who assisted in the epidemic, Dr Lawson Fleck Crummey [31].

From these the progress of the epidemic can be traced, and the identity of the victims established in most cases. Unfortunately, Mr Barlow – never a very assiduous completer of forms, and now overworked and pressed for time – did not enter the cause of death in the burials register. Indeed, there are later deletions and alterations to the register (which he appears to have written up after the event) and some discrepancies between the main register and a duplicate he wrote out at one point, which tend to cast something of a doubt over the accuracy of the entries.

The epidemic, wrote Dr Crummey, was

confined exclusively to the immediate neighbourhood of Cook's residence, and the most malignant cases occurred in houses, the back doors of which opened into a common yard.

A correspondent to the press at the time stated that

it is confined to an extent not exceeding one hundred yards.

The area affected stretched from the immediate neighbourhood of the Bay Horse Yard round to the newly-built houses in Barkers Row. There were other pumps and wells in this area but it must be remembered that before the days of mains water householders often chose which pump to use according to the taste of the water [32]. This accounts for the spread of the disease beyond the yard.

1879 - the area affected by the cholera of 1832

This area – from the house now known as The Elms, which stands immediately to the west of the Bay Horse Inn, to Hutton House on East Side – was the home at the time of the 1841 census of some 167 people, with ten houses unoccupied following the decline in trade and exodus to Middlesbrough. The population in 1832 could be expected to be at least the same, most probably higher. The history of the Hutton epidemic therefore reflects the pattern expected of the disease: of at least 170 people, there were 45 cases, of which 23 were fatal.

The epidemic came swiftly to a peak. Within a week of John Cook's burial on 3 October, 24 people had fallen victim to the cholera, and 12 of them had died. By the end of the second week there had been 43 cases, and 6 further deaths. By 24 October there had been 45 cases and 21 deaths. After that date, no new cases arose, but there were two further deaths.

Mr Barlow and the visiting doctors were evidently able to contain the outbreak. He expected to receive the authority to form a Board of Health and take the measures recommended by government on Wednesday 10 October, but by 9 October he was already fumigating the affected houses with "chloride of lime, common lime and tar".

The use of chloride of lime will have had a disinfecting action, especially if it entered the water supply, as it may well have done given the lie of the land in the Bay Horse Yard. They may also have been helped by rain filling the pumps and wells and diluting the concentration of the contamination. The removal of "nuisances" – the dunghills and undrained privies – will have completed the work. As a result, the epidemic came quickly to an end.

How did Mr Barlow escape infection?

Firstly because he was fortunate in living outside the village at Linden Grove, far from the contaminated water source, but also because he must have been "scrupulously clean in his habits" [33]. As Dr John Snow observed, cholera rarely passed from one family member to another amongst people whose social and economic position in society provided them with the opportunity for "the constant use of the hand-basin and towel" [34].

Unsurprisingly, the Bay Horse Yard was particularly badly hit.

The grocer Henry Bainbridge lost his wife Mary Anne at the age of 41, their 17-year-old daughter Jane and their 13-year-old son William. The baby, baptised in June, survived.

Four members of the Catchasides family died between October 6 and October 8 – the old blacksmith and publican James and his wife Grace, aged 73 and 82, their 39-year-old son Stephen and their daughter Mrs Betty Skelton. Three of these deaths were from cholera.

Mr Pulman, the surgeon, who almost certainly lived in the neighbourhood, probably in 'The Elms', died at the age of 36.

Harriet Passman, aged six, whose father was a saddler near the Wheatsheaf Inn, was a victim, as was probably her younger brother John. The builder John Bainbridge, who lived over the road at the Bank Top end of East Side, lost his four-year-old son Matthew and six-year-old daughter Elizabeth.

Old Jonathan Eland, who had once taught psalmody in church and mended the pitch pipe, died at the age of 82; he lived near 'The Elms'. Thomas Shaw of Barkers Row died in the epidemic, and it is very likely that his wife Jane was also a victim. [35]

Several of the burials in November and December are also of people living in the area affected by cholera – notably the widow of the first victim, Jane Cook, and four members of the Souter family. This is probably the result of an outbreak of typhus that seems to have followed the cholera [36], which would have borne particularly hard on people already weakened by disease.

The outbreak must have seemed most unexpected. Not only did it occur in an area of the village where the houses were quite new, having been rebuilt in the last few years, but respectable families caught the disease, and amongst the dead that autumn – leaving aside the surgeon – were several men of standing in the community.

At least three – 50-year-old Thomas Preston and 39-year-old Stephen Catchasides and his elderly father James – had been active in Vestry matters, indeed James had been for many years a churchwarden. He and Jonathan Eland were both sons of former parish clerks, while Henry Bainbridge, who lost his wife and children, was very active in vestry affairs.

The neighbouring towns were swift to act. Great Ayton appointed an out-of-work weaver to

watch travellers that may be passing through the village [37],

and on October 10 Brompton appointed two special constables to

prevent strangers coming from places where the cholera is raging [38].

Stokesley had evidently already established a Board of Health, or set one up very promptly, as on Monday 8 October their Board held a meeting and issued a notice that

proper persons be appointed to watch night and day, at the outskirts of the Town, to prevent by all lawful means in their power, Vagrants and other Persons coming from Places infected with the Cholera, from entering the Town.

This was printed by John Slater Pratt, an enterprising young man who had begun his career at seventeen taking down the Manor Court proceedings in shorthand, and who had recently inherited his father's business. It was probably Pratt who reported the outbreak to the Leeds Intelligencer, which printed a report on Thursday 11 October:

CHOLERA IN CLEVELAND. – We regret to state that the Asiatic cholera broke out last week at Hutton Rudby, a manufacturing village, near Stokesley.

A linen weaver just returned from Newcastle-on-Tyne, was attacked with this dreadful malady, and in a few hours was a corpse; instead of immediate interment, the body was washed, laid out in due form, and kept till next day, numerous persons being admitted to the room where it was.

Up to Sunday night, there were, we hear, seven deaths: among them three out of four of the family of Catch-a-side, who kept a public-house, the fourth being in a state of extreme danger. On breaking into the house, which was not opened as usual, the master and mistress were found dead, one near the fire; the other in the passage.

Mr. Palmer, the surgeon of the village, was another victim; we understand there were 16 cases in all up to that time.

Hutton Rudby is one of the dirtiest villages imaginable; and its inhabitants, generally, very dissolute.

At Stokesley, the greatest precautions were taken to prevent any communication with the infected village; constables, &c. being stationed at the various entrances to the town. We do not hear of any fresh cases at Stockton or Hartlepool.

A similar version of the death of the Catchasides family was carried on Saturday 13 October by the Yorkshire Gazette, without the derogatory comment on the state of the village and with several new details; it gave the unfortunate surgeon's name as Mr Pullan. The village is described as "nearly deserted", with "about two-thirds of the inhabitants having fled" and Mr Barlow receives flattering notice as having

greatly distinguished himself in visiting the patients and providing for their wants, in every respect possible; furnishing them with food, clothing &c at his own expense.

The deaths of Mrs Bainbridge and her children are recorded in the deaths column and also mentioned in the report, which noted that

another respectable individual has lost his wife and 2 children.

Possibly Mr Bainbridge had himself notified the newspaper, and also given them the information regarding Mr Barlow's kindness.

The story was picked up by the Leeds Mercury, which printed a very brief version on Saturday 13 October, reporting the death of the surgeon and repeating the phrase from the Intelligencer that Hutton Rudby was

one of the dirtiest villages imaginable; and its inhabitants, generally, very dissolute.

The account neatly placed Hutton Rudby as one of the stereotypical communities readers expected to be afflicted by cholera – ignorant, addicted to drink, dirty and immoral – while casting a favourable light on Stokesley. The inaccuracies of the report – not least the surgeon's name incorrectly given – must have caused some distress and indignation in the village.

One irate inhabitant wrote to the Yorkshire Gazette, which obligingly printed his rebuttal and provided a more upbeat report on Saturday 20 October:

The disease is declining at Hutton Rudby, where, in addition to the praiseworthy exertions of the Rev Mr Barlow, the vicar, mentioned in our last, Lord Falkland, Sir Wm Foulis, and other gentlemen, have been extremely active, and they have directed every pecuniary aid to be given in cases of real want. Most of the surgeons residing at Stokesley, Yarm, Stockton, &c have rendered their assistance. Since the commencement of the disease, there have been 42 cases, 16 deaths, and 19 recoveries.-

In reply to some remarks which appeared in the Leeds papers, relative to the dirty state of the place – a correspondent residing there states – that 'so far from Hutton being a dirty village, it is quite the contrary; but like many other manufacturing villages, morality is not so much attended to as it ought.'

Mr Barlow rushed to take up his pen on Monday 15 October but in his haste addressed the response he undoubtedly intended for the Leeds Intelligencer – which might have printed it on Thursday – to the Leeds Mercury. This paper "unfortunately overlooked" the letter, and printed it rather late, on the 27 October, by which time the epidemic was at an end.

His account of the village goes far to explain why the parish had not thought itself vulnerable to cholera – knowing their own worth and their own standards of housekeeping, and naturally ignorant of the dangers of contaminated water, they did not recognise their "nuisances" as dangers:

TO THE EDITORS OF THE LEEDS MERCURY
GENTLEMEN - Having read in your paper of the 13th inst. a statement relative to Hutton Rudby, in Cleveland, which contained in it much that was not the fact; I shall feel obliged by your contradicting it.

So far as, a linen weaver having come from Newcastle, and died in a few hours, is true, but no doctor having seen him, and the man having been ill before, people were induced to think it was not a case of Cholera, and the funeral was carried on as usual, with the exception that the body was not admitted into the church, and that it was buried within fifteen hours from decease, whereas his Majesty’s Order of Council only requires that such bodies be interred within twenty-four hours.

It is true that three of the Catchasides did die of it; but it is utterly false that the house was obliged to be broken open; it is also false that one of them was found dead in the passage, and the other by the fire-side, since I myself was an eye-witness of the whole from the commencement, and visited them in their illness, and I can safely vouch that they had every aid man could give them.

It is likewise asserted that Hutton Rudby is one of the dirtiest villages imaginable. Now it is true that some of the houses are poor looking, and a stranger would be induced to say the town is dirty, but with respect to interior cleanliness, I might without fear of contradiction assert, that there is not a town or village in Cleveland that can surpass it, and few can in that respect equal it.

All this I beg to mention as having come under my own knowledge, being a constant visitant in their houses at all times, and more particularly under the present awful visitation.

I have the honour to be, Gentlemen,

Your obedient servant,

R. J. BARLOW, Clk.
Linden Grove, Hutton Rudby, Oct. 15th, 1832.

The number of cases from the commencement have been 43, deaths 18; the disease thank God is much abated.

His letter is an open declaration of loyalty to his parish, and in a letter published in the same edition of the Mercury can be seen the foundation of his later reputation, and the affection in which he was to be held:

Another correspondent, writing from Hutton Rudby, confirms the statement of our reverend correspondent, and adds –

"I cannot close this letter without noticing the attention paid by the Rev R. J. Barlow, our worthy Vicar to the poor sufferers, early in the morning, during the day, and late at night has he visited them, and done all that man could do to render them comfortable under the pressure of the disease. It is the prevailing opinion here, that, but for his humane and charitable exertions the disease would, ere this, have been spread over the greatest part of the village, whereas it is confined to an extent not exceeding one hundred yards. By his conduct he has acquired a name that will not be forgotten, and he will be hailed as the friend of humanity to the latest period of his existence."

The tireless young clergyman had found his place in his parish. His active help and his generosity would be long remembered.

In many other areas affected by the cholera, money was a particular problem – trade was affected, some vestries were reluctant to pay the necessary costs, and hardship ensued as the community came to an economic standstill. The victims in Hutton Rudby were very fortunate – not only did their local landowners, Lord Falkland and Sir William Foulis, send aid, but their vicar willingly bought food, clothing and medicines for his parishioners with his own money.

After the cholera was over, it disappeared from the press with great rapidity.

The public had tired of the endless speculation and the absence of facts – no conclusions could be drawn, and the epidemic had in the event proved to be much less disruptive and damaging than had been feared before its arrival. Even the medical men were happy to put the debate as to the causes of cholera behind them for a time – until the next invasion of the disease in 1848, when men like Dr Simpson of York and Dr Crummey of Stokesley [39] once more had a chance to consider it.

Similarly, in Hutton Rudby the cholera passed into history. Any wooden crosses erected at the cholera mound eventually disappeared, and several of the families affected left the area. The name Catchasides disappeared from the village records after a presence lasting over 120 years – except for the burials in Rudby churchyard of Eleanor Catchasides and her husband Robert Norman, the papermaker, many years later.

Some months after the epidemic, John Cook's affairs were finally settled by his creditors, the linen manufacturer George Wilson and the cabinet-maker John Eland, who may have been the undertaker. They took out Letters of Administration to his estate in May 1833 [40].

Notes:

[1]Ebor: A History of the Archbishops of York 627-1908 A. Tindal Hart 1986

[2] Dr Thomas Simpson Observations on the Asiatic Cholera: and Facts regarding the mode of its diffusion. London 1849

[5] from A Journal of the Reigns of King George IV and King William IV by the late Charles C F Greville, Esq (from the 1875 edition, ed by Henry Reeve)

[6] Simpson

[7]Cholera 1832 by R J Morris

[8] Dr Clanny's Essay, quoted by Dr Simpson

[9] ibid

[10] diary entry 23 Nov 1832

[11] obituary in Stockton Examiner

[12]The first Spasmodic Cholera epidemic in the North Riding of Yorkshire 1832 by R P Hastings, source for many of the details relating to the North Riding

[13] Dr Simpson Observations on the Asiatic Cholera

[14] Notice of the Stockton Board of Health regarding interment of persons dying of cholera, 25 Aug 1832. Quoted by Tom Sowler, A History of the Town and Borough of Stockton-on-Tees 1972

[15] Great Ayton Select Vestry Minutes 30 Aug 1832, NYCRO

[16]Poor Man's Advocate 28 July 1832, quoted in Morris

[17] 32 pages, copies in the British Library and the Cambridge University Library

[18]Leeds Intelligencer report on cholera in Dumfries, 11 Oct 1832

[19] Macnamara's observation: Cholera 1832 by R J Morris

[20] Dr John Snow On the mode of communication of cholera 1855

[21]Treatise on the Cholera Asphyxia'Edinburgh 1831, quoted by Morris

[22] ibid

[23] with thanks to Jane Cruddas for her description of traditional laying-out practices

[24] or pump; it is shown as a pump in the 1894 Ordnance Survey map

[25] Photographs show a double-pile building on the site, known in the 20th century as Mr T Hall's shop.

[26] Deed of 1816 describes them as "of recent construction"

[27] in his letter to the Leeds Mercury, see below

[28] Dr John Snow On the mode of communication of cholera 1855

[29] Eddowes' history of the parish

[30] As in the case of the Catchasides family, whose tombstone is a little way off. Henry Bainbridge erected a fine sandstone memorial to his lost family near the mound.

[31]The Medical Times 1849 XIX p196-7

[32] cf Snow's account of the Broad Street epidemic. I have had several accounts of this from people who remember the village before mains water. Mr Norman Stockdale of Middleton, for example, described to me some years ago the difference in taste between the pumps he remembered as a child.

[33] Dr John Snow On the mode of communication of cholera 1855

[34] ibid

[35] for a full list of burials, see Appendix II

[36] see R P Hastings' The First Spasmodic Cholera Epidemic in the North Riding of Yorkshire, 1832: the overseers of Catterick reimbursed Hutton in January 1833 for "Pattison's family when in the Cholera and Typhus Fever"

[37] Hastings

[38] ibid

[39] Crummey believed that the disease was contagious, and that it was identical to English cholera, differing only in severity

[40] extracted for me at the Borthwick Institute by Beryl Turner. I realise in revising the text for the blog that there was a typographical error here in the printed book - the date was 1833, not 1831